Referral to emergency

If any of the following are present or suspected, please refer the patient to the emergency department (via ambulance if necessary) or seek emergent medical advice if in a remote region.

  • profound dysphagia, e.g. inability to manage secretions
  • stridor
  • laryngeal obstruction and/or fracture
  • pharyngeal/laryngeal foreign body

For clinical advice, please telephone the relevant metropolitan Local Health Network switchboard and ask to speak to the relevant specialty service.

Central Adelaide Local Health Network

Northern Adelaide Local Health Network

Southern Adelaide Local Health Network

Category 1 — appointment clinically indicated within 30 days

  • suspicion of oropharyngeal lesion - dysphagia and any of the following:
    • hoarseness
    • unilateral otalgia
    • progressive weight loss
    • smoking history, excessive alcohol intake
  • recurrent chest infections (aspiration pneumonia)

Category 2 — appointment clinically indicated within 90 days

  • intermittent dysphagia
  • significant stenotic/dysphagic symptoms and any of the following:
    • gagging, choking, and/or coughing when swallowing
    • food or liquids coming back up to throat, mouth, and/or nose after swallowing
    • feel like foods or liquids are stuck in throat or chest or problems with eating or pain or pressure in chest or heartburn
  • weight loss/loss of appetite/food avoidance
  • shortness of breath post eating in absence of other cause

Category 3 — appointment clinically indicated within 365 days

  • nil

For more on outpatient referrals, see the general referral information page.

Essential referral information

Completion required before first appointment to ensure patients are ready for care. Please indicate in the referral if the patient is unable to access mandatory tests or investigations as they incur a cost or are unavailable locally.

  • identifies as Aboriginal and/or Torres Strait Islander
  • relevant social history, including identifying if you feel your patient is from a vulnerable population and/or requires a third party to receive correspondence on their behalf
  • interpreter requirements
  • presenting complaint history and symptoms
  • neurological assessment/history, e.g. stroke, progressive neurological disease
  • smoking/vaping status - if active, strongly consider referral for smoking/vaping cessation
  • high resolution computerised tomography (CT) neck and chest with contrast, including company and accession number

Additional information to assist triage categorisation

  • thyroid stimulating hormone (TSH)
  • speech pathology report
  • dietetics report
  • chest X-ray
  • barium swallow/modified barium swallow report, include location and accession number

Clinical management advice

Please note that referrals can be managed by the following specialist services:

If acute obstruction caused by a:

  • foreign body at a pharyngeal level (e.g. chicken or fish bone), request acute ear, nose and throat (ENT) assessment
  • soft food bolus that has not cleared, request prompt acute upper gastrointestinal (GI) assessment
  • soft food bolus that has cleared, request gastroenterology assessment

If dysphagia and the most likely cause is:

  • oral or pharyngeal, request ENT assessment
  • oesophageal (e.g., stricture, motility disorder, or malignancy), request upper GI assessment
  • neuromuscular concern, consider neurology or geriatric assessment

If sinister causes excluded, consider adult speech pathology assessment.

Clinical resources

Consumer resources